This invention relates to an electrosurgical instrument for wedge resection, and in particular, an electrosurgical electrode for use in treating entropion.
Entropion is an inward rotation of the eyelid margin resulting in contact between the eyelashes and the cornea, which can cause inflammation and other disorders. A known procedure for treating this condition is to resect a tissue wedge from the underside of the upper eyelid using a traditional scalpel. Closing of the resultant incision tends to rotate the eyelid margin outwardly which sufficiently alters the shape of the eyelid margin as to effectively eliminate the problem.
The procedure is costly and difficult to control, especially the width and thickness of tissue removal, which ideally should be limited to the tarsal width and thickness, the tarsal being the dense connective tissue forming the support of the eyelid.
An object of the invention is an improved wedge resection surgical procedure using an electrosurgical instrument.
We have invented a novel electrode for use in an electrosurgical wedge resection procedure. This electrosurgical procedure using our novel electrode enables physicians to offer to patients a treatment that properly removes the correct amount of tarsal tissue, is easily learned and thus performed at a significantly reduced price, and with less tissue damage and bleeding compared to procedures done with a knife or blade.
The electrosurgical procedure using our novel electrode is based on performing essentially the same kind of wedge resection as was used heretofore but, in accordance with a feature of our invention, the structure of our novel electrosurgical electrode used to make the excision prevents the excision depth and width from exceeding a safe value.
In accordance with another feature of our invention, the electrode of the invention is uniquely configured to form an active thin wire, generally V-shaped, whose width controls the width of a V-shaped tissue groove, and the length of whose arms controls the thickness of the V-shaped tissue groove. The active wire is supported by structure that is completely electrically-insulated to ensure excision only of the desired tissue while avoiding damage to surrounding tissue, and to allow the physician to use these inactive insulated parts to help position and guide the active wire portion, which is the only part capable of incising tissue, and also serves as a stop during the surgical procedure. The electrosurgical procedure has the important advantage of being able to cut the tissue with minimum surgeon pressure while at the same time coagulating the cut tissue causing minimum bleeding. It is preferred that the electrosurgical currents used be above 2 MHz, and preferably above 3 MHz. At these high frequencies, commonly referred to as radiosurgery, cutting is accomplished by volatilizing intracellular fluids at the point of the transmitting electrode contact which is primarily responsible for only small lateral heat spread and thus less damage to neighboring cell layers.
The various features of novelty which characterize the invention are pointed out with particularity in the claims annexed to and forming a part of this disclosure. For a better understanding of the invention, its operating advantages and specific objects attained by its use, reference should be had to the accompanying drawings and descriptive matter in which there are illustrated and described the preferred embodiments of the invention, like reference numerals or letters signifying the same or similar components.